The undermining effects of living with COPD

Based on the definition given by The Global Initiative for Chronic Obstructive Lung Disease (GOLD) chronic obstructive pulmonary disease (COPD) is “a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation…”[1].Consequently, disease treatment and diagnosis are mostly focused on improving the patient’s quality of life while at the same time taking care of disease symptomatology. Based on statistics, COPD exacerbations pose a heavy burden on an individual (frequent hospitalization, increased medication, physical impairment) and societal level (increased financial cost on national budget).

Back in 2010, the American Thoracic Society held a conference symposium titled “Depression and Obstructive Lung Disease: State of the Science and Future Directions” where the need of research on the undermining effects of COPD on mental health was stressed out.  It comes with no surprise that living with COPD can have a negative impact on patient’s mental state as a result of the profound physical impairment. Luckily enough, research findings during the past decade started focusing on the assessment of the mental health state for patients with COPDs indicating that there seems to be a correlation between anxiety, depressive symptomatology and COPD disease [2,3].

Anxiety and depression appear as common comorbidities in COPD and for that reason should be treated accordingly. Evidence support the idea that depressive symptomatology is present when patients face a chronic medical condition (like COPD) that changes the way the experience life (inability to continue working as usual, shifting family roles etc). Another common variable is that patients with COPD not only need to face the physical discomfort of the disease. The degree of awareness of their physical symptoms may amplify their feelings of anxiety and fear thus resulting in poor emotional health. At the same time, depression that is marked by feelings of helplessness and hopelessness, may keep the patient from reporting any physical deterioration or difficulty in keeping up with proper treatment.

Anxiety and depression should be regarded as common comorbidities in COPD and should be treated based on the same protocol adopted for anxiety and mood disorders. Proper diagnosis in COPD should take into consideration the patient’s emotional state that may influence to a great extent the report of symptoms. A collaborative-care model in treating COPD should be the basis of any treatment plan. This is where technological advancements like WELMO take the lead. If we accept that patients may be reluctant or unwilling to report physical discomfort, successful monitoring of lungs state may foster healthcare interventions and help clinicians design a proper treatment protocol thus helping patients improve life quality.

Sophia Vassiliades

WELLICS LTD

[1] Global Initiative for Chronic Obstructive Lung Disease Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. [Accessed December 10, 2019]. Available from: http://www.goldcopd.org/.

[2] Bratek, A., Zawada, K., Beil-Gawelczyk, J., Beil, S., Sozanska, E., Krysta, K. & Pierzchala, W. Depressiveness, symptoms of anxiety and cognitive dysfunctions in patients with asthma and chronic obstructive pulmonary disease (COPD): possible association with inflammation markets: a pilot study. Journal of neural transmission, 122 (1), 83-91.

[3] Hanania, N., Mullerova, H., Locantore N.W., Vestbo., J., Watkings, L.M., Wouters, F.M., Rennard, I.S., Sharafkhaneh, A. Determinants of Depression in the ECLIPSE Chronic Obstructive Pulmonary Disease Cohort. American Journal of Respiratory and Critical Care Medicine ,183 (5).